Outcomes of prostate artery embolisation for benign prostatic hyperplasia in 10 cases at Steve Biko Academic Hospital

Background: Benign prostate hyperplasia (BPH) remains a common cause of lower urinary tract symptoms (LUTS) in ageing men in South Africa and can impact significantly on the quality of life (QOL) of these patients. The Urology Department at Steve Biko Academic Hospital (SBAH) can generally only offer men with LUTS the following treatment options: watchful waiting, medical treatment and surgical management. In men with symptomatic BPH, who are refractory to medical treatment, where anaesthesia is contra-indicated because of co-morbidities or transurethral resection of the prostate (TURP) is contra-indicated because of the prostate size, the Urology and Radiology departments at SBAH recently introduced prostate artery embolisation (PAE).Aim: To assess the outcome of PAE in 10 men with LUTS, secondary to BPH, by comparing their urinary symptoms, QOL and prostate volume before and 3 months after they underwent PAE in the Radiology Department at SBAH.Method: The review included the first 10 men who had undergone therapeutic PAE for symptomatic BPH from May 2016 to September 2016. The subjective symptomatic feedback was assessed according to the International Prostate Symptom Score (IPSS) and the Global Quality of Life questionnaire, created by the American Urological Association (AUA). The reduction in the size of the prostate was measured on magnetic resonance imaging (MRI).Results: Embolisation was technically achieved in all 10 patients. Bilateral embolisation was performed on nine patients. One patient received unilateral embolisation secondary to unilateral tortuous and atherosclerotic changes of the iliac arteries. Within the 3-month follow-up, the mean IPSS score improved by 15.7 points (p < 0.0039), the mean QOL improved by 4.1 points (p < 0.0039) and the mean prostate volume reduction was 21.8 mL (p < 0.0039). Despite improvements observed, there was one clinical failure. No major complications were reported that increased hospital stay, required hospital readmission or required surgery.Conclusion: The study on the first 10 PAE performed in SBAH concludes that PAE is a safe and effective procedure with favourable short-term follow-up results. This indicates that PAE can safely be offered to patients, who are refractory to medical treatment and not suitable candidates for surgery, in urology departments such as in SBAH.

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Responsiveness and minimally important difference of a generic quality of life measure for complementary health practices

Alternative Medicine Studies ◽

10.4081/ams.2012.e12 ◽

2012 ◽

Vol 2 (1) ◽

pp. 12 ◽

Cited By ~ 2

Author(s):

Tomoaki Kimura ◽

Kiyoshi Suzuki ◽

Seiya Uchida ◽

Hiroshi Katamura

Keyword(s):

Quality Of Life ◽

Minimally Important Difference ◽

Health Practices ◽

Life Questionnaire ◽

Age Group ◽

Japanese Adults ◽

The Mean ◽

Generic Quality

Shorter and easier methods of conducting community health surveys would be useful. We conducted a study to demonstrate the responsiveness of the 10-item Mokichi Okada Association quality of life questionnaire (MQL-10) in a follow-up survey and to determine the minimally important difference (MID) for this measure. In 2007, Japanese adults participated in a survey on health prac- tices. We analyzed the MQL-10 scores (n=6365) together with the following factors: gender, age group, disease, reason for participation, and complementary health practices, such as food and eating. The mean baseline MQL-10 score was 26.4±5.83 [standard deviation (SD)] and the mean follow-up score was 27.6±5.45 SD with a mean change of 1.20±4.41 SD. The effect size for change was 0.21 and the standardized response mean was 0.27. The MQL-10 scores in the baseline condition were associated with gender, age group, disease, reason for participation and complementary health practices. Furthermore, the changes in the MQL-10 during the 12 weeks of study were associated with age group, disease, reason for participa- tion and complementary health practices. The increase in frequency of health practices was significantly associated with improvements in the participants’ quality of life (QOL). These results suggest that the MQL-10 is use- ful for assessing the effects of complementary health practices on QOL. The estimate of 3 points for the range of this measure (0-40) was higher than half of the SD of scores; therefore, it was considered reasonable for the MID.

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Interpreting the significance of changes in health-related quality-of-life scores.

Journal of Clinical Oncology ◽

10.1200/jco.1998.16.1.139 ◽

1998 ◽

Vol 16 (1) ◽

pp. 139-144 ◽

Cited By ~ 1723

Author(s):

D Osoba ◽

G Rodrigues ◽

J Myles ◽

B Zee ◽

J Pater

Keyword(s):

Quality Of Life ◽

Effect Sizes ◽

Life Questionnaire ◽

Health Related Quality ◽

European Organization ◽

Global Quality Of Life ◽

Related Quality ◽

Health Related ◽

The Mean

PURPOSE To determine the significance to patients of changes in health-related quality-of-life (HLQ) scores assessed by the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30). PATIENTS AND METHODS A subjective significance questionnaire (SSQ), which asks patients about perceived changes in physical, emotional, and social functioning and in global quality of life (global QL) and the QLQ-C30 were completed by patients who received chemotherapy for either breast cancer or small-cell lung cancer (SCLC). In the SSQ, patients rated their perception of change since the last time they completed the QLQ-C30 using a 7-category scale that ranged from "much worse" through "no change" to "much better." For each category of change in the SSQ, the corresponding differences were calculated in QLQ-C30 mean scores and effect sizes were determined. RESULTS For patients who indicated "no change" in the SSQ, the mean change in scores in the corresponding QLQ-C30 domains was not significantly different from 0. For patients who indicated "a little" change either for better or for worse, the mean change in scores was about 5 to 10; for "moderate" change, about 10 to 20; and for "very much" change, greater than 20. Effect sizes increased in concordance with increasing changes in SSQ ratings and QLQ-C30 scores. CONCLUSION The significance of changes in QLQ-C30 scores can be interpreted in terms of small, moderate, or large changes in quality of life as reported by patients in the SSQ. The magnitude of these changes also can be used to calculate the sample sizes required to detect a specified change in clinical trials.

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Health-related quality of life in the randomized phase 3 study of ramucirumab plus docetaxel versus placebo plus docetaxel in platinum-refractory advanced urothelial carcinoma (RANGE)

BMC Urology ◽

10.1186/s12894-020-00752-w ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Andrea Necchi ◽

Hiroyuki Nishiyama ◽

Nobuaki Matsubara ◽

Jae-Lyun Lee ◽

Daniel P. Petrylak ◽

...

Keyword(s):

Quality Of Life ◽

Urothelial Carcinoma ◽

Life Questionnaire ◽

Phase 3 ◽

Patient Reported ◽

Global Quality Of Life ◽

Platinum Refractory ◽

Advanced Urothelial Carcinoma

Abstract Background To evaluate patient-reported outcomes with ramucirumab plus docetaxel, a regimen which improved progression-free survival in platinum-refractory advanced urothelial carcinoma (aUC). Methods RANGE—a randomized, double-blinded, phase 3 trial in patients with platinum-refractory aUC. Ramucirumab (10 mg/kg) plus docetaxel (75 mg/m2) or placebo plus docetaxel were administered every 21 days until disease progression or unacceptable toxicity. Patients received maximum 10 cycles of docetaxel. European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) and EuroQoL five-dimensions (EQ-5D-5L) were administered at baseline, start of each cycle, and 30-day follow-up visit. A ≥ 10-point change in QLQ-C30 scores was considered meaningful. Rates of improved/stable scores were compared between treatment arms using Fisher’s exact test. Time to deterioration (TtD) was estimated and compared using Kaplan–Meier estimation and log-rank test. Results Of the 530 patients, ~ 97% patients in each arm provided baseline QLQ-C30 data. On-treatment compliance was ≥ 88% for first 8 cycles. Mean baseline QLQ-C30 scores were similar between arms, with global quality of life (QoL), fatigue, pain, and insomnia having greatest impairment. Postbaseline rates of improved/stable QLQ-C30 scores were similar between treatment arms except for greater improvement in pain score with ramucirumab. TtD of QLQ-C30 scales favored ramucirumab arm. Baseline EQ-5D-5L index and visual analogue scale scores were similar between arms, followed by relatively stable on-treatment scores. EQ-5D-5L scores worsened at post-discontinuation follow-up visit. Conclusions Ramucirumab plus docetaxel did not negatively impact QoL compared with docetaxel alone in platinum-refractory aUC. Improved TtD and tumor associated rates of pain favored ramucirumab treatment. Clinical trail registration NCT02426125. https://clinicaltrials.gov/ct2/show/NCT02426125. Date of registration: April 24th 2015

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Variability and Sample Size Requirements of Quality-of-Life Measures: A Randomized Study of Three Major Questionnaires

Journal of Clinical Oncology ◽

10.1200/jco.2005.07.141 ◽

2005 ◽

Vol 23 (22) ◽

pp. 4936-4944 ◽

Cited By ~ 45

Author(s):

Yin-Bun Cheung ◽

Cynthia Goh ◽

Julian Thumboo ◽

Kei-Siong Khoo ◽

Joseph Wee

Keyword(s):

Quality Of Life ◽

Sample Size ◽

Effect Size ◽

Performance Status ◽

Life Questionnaire ◽

Global Quality Of Life ◽

Eortc Qlq C30 ◽

Eortc Qlq

PurposeTo compare the variability and sample size requirements of the global quality-of-life (QOL) scores of the following three major QOL instruments: the Functional Assessment of Cancer Therapy–General (FACT-G), Functional Living Index–Cancer (FLIC), and European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire C30 (EORTC QLQ-C30).Patients and MethodsCancer patients were randomly assigned to answer two of the three instruments using an incomplete block design (n = 1,268). The instruments were compared in terms of coefficient of variation, effect size in detecting a difference between patients with different performance status, and correlation coefficient between scores at baseline and follow-up.ResultsThe FACT-G and FLIC had significantly smaller coefficients of variation than the EORTC QLQ-C30 (both P < .05). The FLIC also had significantly larger correlation coefficients between scores at baseline and follow-up than the EORTC QLQ-C30 (P < .05). The FACT-G and the FLIC had a larger effect size in a cross-sectional and longitudinal setting, respectively, than the EORTC QLQ-C30 in differentiating patients with different performance status (both P < .05).ConclusionIn some aspects, the FACT-G and FLIC global QOL scores had smaller variability and larger discriminative ability than the EORTC QLQ-C30. Further research using other criteria to compare the three instruments is recommended.

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Quality of Life Assessment for Patients with Multiple Myeloma after Tandem Autologous Stem Cell Transplantation

Blood ◽

10.1182/blood.v112.11.2398.2398 ◽

2008 ◽

Vol 112 (11) ◽

pp. 2398-2398

Author(s):

Alhossain Khalafallah ◽

Kristina McDonnell ◽

Susie Shaw ◽

Hizb Dawar ◽

Michael Beamish ◽

...

Keyword(s):

Quality Of Life ◽

Multiple Myeloma ◽

Stem Cell ◽

Stem Cell Transplantation ◽

Post Transplant ◽

Global Quality ◽

Global Quality Of Life ◽

The Mean

Abstract Background: A sole focus on life prolongation does not adequately reflect the tolerability and acceptability of a proposed intervention on the patient’s perceived quality of life. As healthcare providers, our primary concern is to our patients and therefore, we should utilise measures of overall survival in conjunction with quality of life in order to deliver the best possible patient outcomes as guided by an individualised approach. Patients and methods: We assessed patients diagnosed with multiple myeloma who were undergoing tandem autologous stem cell transplantation (ASCT) according to our protocol at the Launceston General Hospital (LGH) from March 2006 to March 2008. Patients aged below 60 years received a conditioning regimen with 140mg/m2 Melphlan, while patients above 60 years received 100mg/m2 Melphalan. Of the twenty recruited patients with multiple myeloma undergoing tandem ASCT, 17 were eligible for assessment of quality of life. The median age was 49 years (range 37–70 years). A full patient profile was collected including demographic and medical data and risk factors for multiple myeloma. Assessment of quality of life was made using The European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life QLQ-C30 questionnaire, conducted via interviews directly after each transplant and regularly thereafter every 3 months. The tandem transplants were well tolerated without any reported cases of mucositis or nausea or vomiting that requires parenteral nutrition. Results: Assessment of the gastrointestinal symptoms during both transplants showed that about 70% of the patients suffered from some degree of nausea and vomiting as well as loss of appetite compared to only 6–10% post transplant on further follow up. About 57% of patients suffered mild to moderate constipation and 35% complained of diarrhoea during both transplants. In the first quarterly follow up post transplant 45% of the patients had mild constipation most likely related to ongoing medication for myeloma and pain and no patients complained of diarrhoea. Assessment of patient role showed that 90% of patients had moderate to severely-affected normal social activities during both transplants with an improvement to 20–40% impairment after transplant in further quarterly follow up mainly due to chronic disease. Approximately 55% of patients experienced emotional disability during both transplants compared to 20% post transplant. None of them required specific treatment. Interestingly, about 70% reported significant financial difficulties during transplants compared to 40% after transplant follow up. About 50% of patients after each transplant have experienced moderate fatigue, mild dyspnoea and mild physical impairment. In the 3 monthly follow up this declined to 20%. Also, 50% of patients did complain to some degree of insomnia during both transplants with further improvement to 13 % after transplant. Assessment of quality of life revealed that the mean Global Health measure to be 3.44 (1=very poor, 7=excellent), and a mean Global Quality of Life of 3.61. There were no statistical differences in both scores between both transplants. However, the mean Global Health score significantly improved to 4.50 and the mean Global Quality of Life to 4.71 at quarterly follow-up. In summary, our analysis shows that dose-modified tandem transplant therapy is well tolerated with acceptable toxicity and side effects albeit the significant changes in quality of life during both transplants. Nevertheless, the post transplant follow up showed significant improvement in the quality of life that certainly reflects positively in the overall disease outcome.

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Postoperative Results of Off-Pump Coronary By-pass Grafting in Elderly Patients: A Single Center Experience

The Open Cardiovascular Medicine Journal ◽

10.2174/1874192400903010015 ◽

2009 ◽

Vol 3 (1) ◽

pp. 15-20 ◽

Cited By ~ 2

Author(s):

M Biçer ◽

B Özdemir ◽

R İşçimen ◽

D Saba ◽

M Yanar ◽

...

Keyword(s):

Quality Of Life ◽

Elderly Patients ◽

Coronary Bypass ◽

Life Assessment ◽

Life Questionnaire ◽

Postoperative Results ◽

Off Pump ◽

The Mean

Aim: We aimed to report our postoperative results in elderly patients that had off-pump coronary bypass grafting. Method: Data of 173 patients with isolated coronary bypass 70 years of age or older were retrospectively evaluated. One month follow-up data were evaluated in all patients. After getting verbal informed consent a total of 91 patients were included in the quality of life assessment via EuroQoL form. The data of patients with age of 70-74 and 75 or older were compared. Results: The mean ages of patients at age of 70-74 and ≥75 were 71.69±0.16 and 76.81±0.23 years; respectively. Eleven cases had in-hospital mortality (%6 of 173 patients). The mean follow-up period for the group that were reached for EuroQoL assessment was 46,3 ± 20,8 months. The percent of cases among the whole study group that had participated in the quality of life questionnaire were in good condition in terms of mobility, self-care, usual activities, pain/discomfort, anxiety/depression were %75, %87, %81, %92 and %89; respectively. Discussion: Off-pump coronary bypass operation may be safely used in elderly patients with high quality of life and low morbidity and mortality.

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The Effect of Laughter Yoga on the Quality of Life of Elderly Nursing Home Residents

Caspian Journal of Neurological Sciences ◽

10.32598/cjns.5.16.7 ◽

2019 ◽

Vol 5 (1) ◽

pp. 7-15

Author(s):

Sajjad Rezaei ◽

◽

Maryana Mahfeli ◽

Seyed Valiollah Mousavi ◽

Shima Poorabolghasem Hosseini ◽

...

Keyword(s):

Quality Of Life ◽

Nursing Home ◽

Elderly People ◽

The Elderly ◽

Life Questionnaire ◽

Significant Difference ◽

The Mean ◽

Experimental Group

Background: Old age is associated with the physical and psychological problems that affect the Quality of Life (QoL). Objectives: This study aimed to investigate the effect of Laughter Therapy (LT) on the QoL of elderly people in nursing homes. Materials & Methods: This was a quasi-experimental study with‌ pre-test and post-test with the control and experimental group and one-month follow-up conducted in 2017. The statistical population consisted of 44 elderly people in the Mehr Aein nursing home in Astaneh-ye Ashrafiyeh City, Iran. Based on the inclusion criteria, 32 old people were selected and randomly assigned to experimental ‌(n=16) and control (n=16) groups. The experimental group received an interventional program consisting of Madan Kataria Laughter Therapy, showing comic films, and reading comic books for one month, over 12 sessions of 100 minutes. After the end of laughter intervention, the elderly of both groups responded to the elderly quality of life questionnaire (LIPAD). The obtained data were analyzed using covariance analysis of repeated measures. Results: There was a significant difference between the two groups with regard to their QoL‌ (P<0.01).‌ That is, the adjusted mean of the experimental group in the QoL was significantly higher than the mean of the control group‌ (P<0.01). Also, in the experimental group, the mean follow-up score was higher than the mean score of the pre-test, which indicates the stability of the intervention effects after one month‌ (P<0.01). Conclusion: Laughter Therapy intervention has a positive effect on improving the QoL of the elderly. Therefore, it is necessary that authorities consider this program at nursing home centers as a complementary method besides the existing treatments for reducing the mental health problems and improving the QoL of the elderly.

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Cathartic Effect of Suicide Attempts Not Limited to Depression

Crisis ◽

10.1027//0227-5910.24.2.73 ◽

2003 ◽

Vol 24 (2) ◽

pp. 73-78 ◽

Cited By ~ 21

Author(s):

Yves Sarfati ◽

Blandine Bouchaud ◽

Marie-Christine Hardy-Baylé

Keyword(s):

Quality Of Life ◽

Depressive Symptoms ◽

Personality Traits ◽

Rating Scales ◽

Suicide Attempts ◽

World Health ◽

Life Questionnaire ◽

Short Term

Summary: The cathartic effect of suicide is traditionally defined as the existence of a rapid, significant, and spontaneous decrease in the depressive symptoms of suicide attempters after the act. This study was designed to investigate short-term variations, following a suicide attempt by self-poisoning, of a number of other variables identified as suicidal risk factors: hopelessness, impulsivity, personality traits, and quality of life. Patients hospitalized less than 24 hours after a deliberate (moderate) overdose were presented with the Montgomery-Asberg Depression and Impulsivity Rating Scales, Hopelessness scale, MMPI and World Health Organization's Quality of Life questionnaire (abbreviated versions). They were also asked to complete the same scales and questionnaires 8 days after discharge. The study involved 39 patients, the average interval between initial and follow-up assessment being 13.5 days. All the scores improved significantly, with the exception of quality of life and three out of the eight personality traits. This finding emphasizes the fact that improvement is not limited to depressive symptoms and enables us to identify the relative importance of each studied variable as a risk factor for attempted suicide. The limitations of the study are discussed as well as in particular the nongeneralizability of the sample and setting.

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Utilization of laser interstitial thermotherapy guided by real-time thermal MRI as an alternative to separation surgery in the management of spinal metastasis

Journal of Neurosurgery Spine ◽

10.3171/2015.2.spine141185 ◽

2015 ◽

Vol 23 (4) ◽

pp. 400-411 ◽

Cited By ~ 48

Author(s):

Claudio E. Tatsui ◽

R. Jason Stafford ◽

Jing Li ◽

Jonathan N. Sellin ◽

Behrang Amini ◽

...

Keyword(s):

Quality Of Life ◽

Spinal Cord ◽

Real Time ◽

Spinal Cord Compression ◽

Spinal Metastasis ◽

Cord Compression ◽

The Mean ◽

Interstitial Thermotherapy

OBJECT High-grade malignant spinal cord compression is commonly managed with a combination of surgery aimed at removing the epidural tumor, followed by spinal stereotactic radiosurgery (SSRS) aimed at local tumor control. The authors here introduce the use of spinal laser interstitial thermotherapy (SLITT) as an alternative to surgery prior to SSRS. METHODS Patients with a high degree of epidural malignant compression due to radioresistant tumors were selected for study. Visual analog scale (VAS) scores for pain and quality of life were obtained before and within 30 and 60 days after treatment. A laser probe was percutaneously placed in the epidural space. Real-time thermal MRI was used to monitor tissue damage in the region of interest. All patients received postoperative SSRS. The maximum thickness of the epidural tumor was measured, and the degree of epidural spinal cord compression (ESCC) was scored in pre- and postprocedure MRI. RESULTS In the 11 patients eligible for study, the mean VAS score for pain decreased from 6.18 in the preoperative period to 4.27 within 30 days and 2.8 within 60 days after the procedure. A similar VAS interrogating the percentage of quality of life demonstrated improvement from 60% preoperatively to 70% within both 30 and 60 days after treatment. Imaging follow-up 2 months after the procedure demonstrated a significant reduction in the mean thickness of the epidural tumor from 8.82 mm (95% CI 7.38–10.25) before treatment to 6.36 mm (95% CI 4.65–8.07) after SLITT and SSRS (p = 0.0001). The median preoperative ESCC Grade 2 was scored as 4, which was significantly higher than the score of 2 for Grade 1b (p = 0.04) on imaging follow-up 2 months after the procedure. CONCLUTIONS The authors present the first report on an innovative minimally invasive alternative to surgery in the management of spinal metastasis. In their early experience, SLITT has provided local control with low morbidity and improvement in both pain and the quality of life of patients.

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TOLTERODINE IMPROVES QUALITY OF LIFE IN PATIENTS WITH AN OVERACTIVE BLADDER, WITH OR WITHOUT URINARY INCONTINENCE: A PROSPECTIVE MULTICENTER STUDY

Urogynaecologia ◽

10.4081/uij.2008.1.5 ◽

2010 ◽

Vol 22 (1) ◽

pp. 5

Author(s):

F. Mantovani ◽

G. Bozzini ◽

P. Acquati ◽

S.S. Di Pierro ◽

M.G. Spinelli ◽

...

Keyword(s):

Quality Of Life ◽

Overactive Bladder ◽

Clinical Effects ◽

Health Questionnaire ◽

Prospective Multicenter Study ◽

Study Materials ◽

Trial Entry ◽

The Mean

AIMS: In order to analyse the effect of tolterodine on the Quality of life (QoL) of patients with overactive bladder (OB) we conducted a prospective multicentre clinical study. MATERIALS AND METHODS: Subjects were questioned at entry and 4, 12 and 24 weeks later about the number of micturitions and incontinent and urgency episodes/day, using a micturition diary. The mean volume voided per micturition and the number of pads used per day was also recorded. The QoL was measured using the Kings Health Questionnaire (KHQ) and the Incontinence Impact Questionnaire (IIQ). A total of 179 patients entered the study: 59 dropped out (4 due to lack of efficacy, 10 due to adverse events, 25 because of lack of interest in the study/other reason and 20 were lost at follow up), leaving 120 patients for analysis. One hundred and eight patients (90%) were female, their mean age was 56.5 years (SD 11.2); 87 had never received treatment for OB/UI (80.6%) and their mean weight was 70.0 Kg (SD 12.7). RESULTS: The mean number of micturitions/day was 9.3 at trial entry and it decreased to 6.8 by the end of the study. The corresponding values for the number of urge episodes, incontinence episodes and number of pads used per day were 3.5, 2.7 and 1.2 and 0.8, 0.9 and 0.4 respectively. The mean volume voided per micturition increased from 146 ml. to 178 ml. All the differences between trial entry and end of study values were statistically significant (p<0.05). Considering the results of the KHQ, the values of all the different areas/domini (?) decreased markedly and in a statistically significant way between the start of treatment and the end of study evaluations. Similar findings emerged when we considered values of the IIQ. The decrease was constant and marked during the first three months and remained constant thereafter. CONCLUSIONS: This study, conducted in a population of subjects with dry and wet OB, shows that tolterodine given for six months lowers the frequency of urgency episodes and incontinence episodes without troublesome adverse effects. These clinical effects are mirrored in the QoL, KHQ and IIQ questionnaire scores, which improved by about 50% over the same period.

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